Clinically advanced pelvic squamous cell carcinomas (pSCC) in men and women: A comprehensive genomic profiling (CGP) study.

Authors

null

Philippe E. Spiess

Moffitt Cancer Center, Tampa, FL

Philippe E. Spiess , Petros Grivas , Douglas A. Mata , Gennady Bratslavsky , Joseph M Jacob , Andrea Necchi , Natalie Danziger , Douglas I. Lin , Brennan Decker , Ethan Sokol , Richard S.P. Huang , Jeffrey S. Ross

Organizations

Moffitt Cancer Center, Tampa, FL, University of Washington, Fred Hutchinson Cancer Research Center, Seattle Cancer Care Alliance, Seattle, WA, Foundation Medicine, Inc, Cambridge, MA, SUNY Upstate University Hospital, Bethesda, MD, Upstate Medical University, Syracuse, NY, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy, Foundation Medicine, Cambridge, MA, Cancer Genomics Research, Foundation Medicine, Cambridge, MA

Research Funding

Pharmaceutical/Biotech Company
Foundation Medicine Inc

Background: Given that the clinical manifestations, disease course, and treatment options for pSCC differ between tumor types, we performed CGP to examine possible genomic differences. Methods: 1,741 clinically advanced pSCCs including 230 penile (penSCC), 17 male urethral (murthSCC), 125 male anal (manSCC), 7 female urethral (furthSCC), 263 vulvar (vulSCC), 822 cervical (crvSCC), and 277 female anal SCCs (fanSCC) underwent hybrid capture-based CGP to evaluate all classes of genomic alterations (GAs). Tumor mutational burden (TMB) was determined on up to 1.1 Mb of sequenced DNA and microsatellite instability (MSI) was determined on up to 114 loci. PD-L1 expression was determined by IHC (Dako 22C3). Results: HPV-16/18 detection was lowest in murthSCC and vulSCC and highest in manSCC, fanSCC, and crvSCC. TP53 GAs were inversely associated with HPV status. PIK3CA GA frequency varied (22-43%). DNA-damage response (DDR) GAs (e.g., BRCA1/2, ATM, others) were low ( < 1-3%) throughout. Cell-cycle GAs were most frequent in external cases (penSCC, furthSCC, vulSCC). MTOR pathway GAs (PTEN, FBXW7) were the most frequently identified “actionable” GAs. FGFR3 GA were present in >5% of murthSCC, crvSCC, and fanSCC; other receptor-tyrosine kinase (RTK) targeted options were 1% in BRAF/ERBB2. NOTCH1 GAs were present in > 15% of penSCC and vulvSCC. TMB ≥10 mut/Mb was >15% in manSCC, fanSCC, and crvSCC. PD-L1 low expression was > 25% in all pSCC except crvSCC and high expression was > 18% in all pSCC except urthSCC and manSCC. Conclusions: Despite similar histology, pSCC differ widely in GAs and HPV status. PIK3CA is the most frequent “targetable” GA followed by MTOR pathway and cell cycle; RTK targets are extremely rare. PARP inhibitor options appear low given the infrequent finding of DDR GAs. Anti-PD(L)1 could be considered in a number of cases based on TMB>10 mut/Mb and PD-L1 expression.


Penile SCC (n = 230)
Male Urethral SCC (n = 17)
Male Anal SCC (n = 125)
Female Urethral SCC (n = 7)
Vulvar SCC (n = 263)
Cervical SCC (822)
Female Anal SCC (n = 277)
Median age (range), yrs
65 (24-92)
63 (40-76)
60 (26-89+)
61 (49-75)
64 (29-89+)
51 (22-89+)
62 (35-89+)
HPV-6/11 (low risk)
3%
0%
6%
0%
1%
< 1%
1%
HPV-16/18 (high risk)
29%
12%
73%
43%
25%
68%
90%
BRCA1
< 1%
0%
3%
0%
2%
1%
2%
BRCA2
3%
0%
3%
0%
2%
3%
1%
CCND1 amplification
15%
6%
6%
0%
18%
3%
3%
CD274 amplification
6%
0%
2%
0%
5%
4%
4%
CDKN2A/B inactivation
47%/9%
24%/0%
15%/8%
43%/14%
37%/7%
4%/2%
4%/2%
EGFR amplification
14%
12%
1%
0%
10%
3%
2%
FBXW7
8%
6%
15%
29%
7%
14%
16%
FGFR3
3%
6%
2%
0%
1%
5%
5%
NOTCH1
17%
0%
8%
0%
17%
5%

PIK3CA
22%
30%
34%
29%
23%
43%
38%
PTEN inactivation
4%
6%
7%
0%
5%
13%
18%
TERT promoter mutation
44%
13%
10%
29%
56%
16%
5%
TP53
55%
59%
18%
43%
65%
10%
9%
MSI High
1%
0%
< 1%
0%
< 1%
1%
1%
Median TMB
3.8
3.8
5.0
3.8
3.8
5.0
5.0
TMB >10 mut/Mb
15%
6%
24%
0%
11%
27%
22%
PD-L1 Low Positive (1-49%)
25%
28%
(n = 60) 50%
(n = 4) 75%
(n = 143) 43%
(n = 22) 9%
(n = 112) 48%
PD-L1 High Positive (≥50%)
34%
14%
18%
0%
33%
27%
22%

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Abstract Details

Meeting

2021 ASCO Annual Meeting

Session Type

Poster Session

Session Title

Developmental Therapeutics—Molecularly Targeted Agents and Tumor Biology

Track

Developmental Therapeutics—Molecularly Targeted Agents and Tumor Biology

Sub Track

Tissue-Based Biomarkers

Citation

J Clin Oncol 39, 2021 (suppl 15; abstr 3130)

DOI

10.1200/JCO.2021.39.15_suppl.3130

Abstract #

3130

Poster Bd #

Online Only

Abstract Disclosures

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